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- Volume 3, Issue 1, 2011
Southern African Journal of Gynaecological Oncology - Volume 3, Issue 1, 2011
Volume 3, Issue 1, 2011
Author Greta DreyerSource: Southern African Journal of Gynaecological Oncology 3 (2011)More Less
The editorial board of SAJGO aims to publish original South African research reports. We would like to not only be the mouthpiece of the SASGO, but also the preferred journal for all our members to publish locally relevant research findings. Two articles that appear in the current journal report on research conducted on the diagnostic and therapeutic aspects of endometrial cancer. Although not all experts will agree that frozen section is an important step in the operative management of this cancer, it is important to reflect on its usefulness. This discussion also opens, once again, the debate on the role of lymph node dissection. In my opinion, it is high time that we agree that more than one "correct" approach exists, and that we do not have a perfect set of rules that will apply to all patients and all surgeons.
Author Manivasan MoodleySource: Southern African Journal of Gynaecological Oncology 3, pp 5 –6 (2011)More Less
Cervical cancer staging remains one of the oldest staging systems for malignancies in the history of cancer. The initial professional body responsible for cervical cancer staging was the Radiological Sub-Commission of the Cancer Commission of the Health Organization of the League of Nations founded in 1928. Annual reports were published by the same commission and, in 1958, the International Federation of Gynaecology and Obstetrics (FIGO) became the official patron of the annual report. The FIGO Committee on Gynaecologic Cancer undertakes the responsibility to review and make recommendations to changes in the staging systems, based on available scientific information. Since the initial staging publication, there have been eight changes to the staging system for cervical cancer, with the most recent being in 2009. Thus far, most of the changes have pertained to stage I and its sub-stages.
Understanding and incorporating human papillomavirus testing in cervical cancer screening : a South African perspective : reviewAuthor K.L. RichterSource: Southern African Journal of Gynaecological Oncology 3, pp 9 –14 (2011)More Less
The identification of human papillomavirus (HPV) as the aetiological agent for cervical cancer has important implications for the future of cervical cancer screening and prevention strategies. Despite the availability of HPV vaccines, regular and adequate screening will remain the mainstay of cervical cancer screening for some time to come. Molecular tests for high-risk HPV DNA and E6/E7 mRNA have the potential to improve cervical cancer screening in developed and developing countries. The latest international and South African private sector guidelines propose the incorporation of molecular testing for HPV in screening and patient management, backed by good scientific evidence. It is a time of transition for screening programmes; a move from the annual Pap test to a new viral paradigm. This review discusses the proper placement, advantages and disadvantages of cytology versus HPV-based screening tests from a South African perspective.
Source: Southern African Journal of Gynaecological Oncology 3, pp 16 –26 (2011)More Less
The human epidermal growth factor receptor 2 (HER2) is overexpressed in HER2-positive breast cancer. This confers characteristics associated with an overall poor prognosis, with early metastases to major visceral sites and a relative resistance to chemotherapy. Trastuzumab is a humanised monoclonal therapeutic antibody that specifically targets HER2 receptor overexpressing breast cancer cells, inhibiting their growth and proliferation, and inducing their regression. It is licensed for metastatic and early HER2-positive breast cancer, determined by slide-based testing techniques. Trastuzumab dosing regimens are aimed at increasing its efficacy, while minimising its potentially undesirable effects which include cardiotoxicity and the development of resistance.
The role of frozen section in the management of early endometrioid endometrial carcinoma : original researchSource: Southern African Journal of Gynaecological Oncology 3, pp 29 –33 (2011)More Less
Objective: To assess the accuracy of intraoperative frozen section in patients with early endometrioid adenocarcinoma of the endometrium.
Methods: Frozen section was compared with definitive histology in patients with early endometrioid adenocarcinoma of the endometrium. Prognostic factors such as grade, depth of invasion and cervical involvement were compared to assess whether frozen section could make a contribution in identifying patients who were at risk of lymph node metastases.
Results: There were 61 patients who met the inclusion criteria. Frozen section was correct when compared to definitive histology in 93.5% of cases. For depth of invasion and cervical involvement, frozen section was correct in 95.1% and 90% of cases respectively.
Conclusion: Frozen section seems, in this study, to be a useful intraoperative tool to identify patients who are at risk of lymph node metastases.
Endometrial sampling : a comparison between the Pipelle® endometrial sampler and the Endosampler® : original researchSource: Southern African Journal of Gynaecological Oncology 3, pp 34 –38 (2011)More Less
Objective: To compare the adequacy of endometrial sampling by the Endosampler® and the Pipelle®.
Methods: A total of 68 women were randomly assigned to submit to pre-hysterectomy endometrial sampling, either by the Endosampler® or the Pipelle®. The amount of endometrial tissue sampled was measured by calculating the percentage endometrium sampled by each of the two devices. Acceptance by the gynaecologist was measured on a linear scale.
Results: The Endosampler® sampled significantly more endometrial tissue than the Pipelle® endometrial sampler (p-value = 0.03). Acceptance of the Endosampler® was better than that of the Pipelle® (p-value = 0.0005). With the use of the Pipelle®, three significant endometrial lesions were missed, including endometrial carcinoma in one instance.
Conclusion: The Endosampler® appears to be an easy-to-use device for endometrial sampling, with reliable diagnostic yield.
Prophylactic human papillomavirus vaccination against cervical cancer : a summarised resource for clinicians : guidelinesSource: Southern African Journal of Gynaecological Oncology 3, pp 39 –42 (2011)More Less
Carcinoma of the cervix remains the most frequent cancer affecting women in South Africa. Twenty-three per cent of all reported cancers in women are of the uterine cervix. Cancer of the cervix resulted in an estimated 3 700 deaths in South Africa during 2002.
The human papillomavirus (HPV) has been proven a potent carcinogen. The aetiological role of HPV infection in the development of preinvasive and invasive lesions of the cervix, vagina and the anogenital region has been conclusively established. Vaccination against infection with specific high-risk HPV is commercially available, and is likely to change the future of the disease.
Source: Southern African Journal of Gynaecological Oncology 3, pp 43 –45 (2011)More Less
Haemangioma of the cervix is an extremely rare benign lesion, and only a few sporadic cases have been reported. Haemangiomas are benign tumors that originate from endothelial cells of the blood vessels, which represent multipotent cellular elements, or from pericytes located on the outer side of the blood vessel wall. These vascular lesions may be asymptomatic or may cause abnormal vaginal bleeding which may be, rarely, life threatening. The epithelium covering these haemangiomas is usually intact but, in exposed areas like the cervix and the vagina, traumatic ulceration of the overlying epithelium may create a lesion that tends to bleed on slight contact or trauma.
We report a case of cervical haemangioma, a cause of postcoital bleeding, which was managed successfully by a conservative procedure.
Obstetrics and Gynaecology Update Congress 2011 : South African Society of Gynaecological Oncology Workshop, CSIR Convention Centre, 5-7 May 2011 : abstractsSource: Southern African Journal of Gynaecological Oncology 3, pp 46 –47 (2011)More Less